Individual
DIANE KATHLEEN PASTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
4 LORD JOES LNDG, NORTHPORT, NY 11768-1570
(631) 754-6819
Mailing address
4 LORD JOES LNDG, NORTHPORT, NY 11768-1570
(631) 754-6819
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305997-1
NY
Other
Enumeration date
05/01/2012
Last updated
05/01/2012
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